Relationship between assertiveness of new nursing staff and their perceptions of their working environment

―Systematic Review―

Abstract

This review clarifies the relationship between assertiveness of new nursing staff and their perception of the work environment. A systematic review was described in Ichushi (Igaku Chuo Zasshi, Japan Medical Abstracts Society) and PubMed (PubMedⓇ) in 2020 in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search keywords used were “new nurses," “assertiveness," and “work environment." From the 2721 articles extracted (82 Ichushi cases and 2639 PubMed cases), ten met the selection criteria and were analyzed. While there are two existing scales to measure the assertiveness of new nursing staff, measuring the assertiveness unique to Japanese nurses and interpreting the analyzed results is difficult. Moreover, there is no specific scale to evaluate their work environment. Therefore, questionnaires were used to inquire about their amount of work and whether they had advisers. New nurses with low assertiveness scores on “personal accomplishment" showed high burnout scores, with an odds ratio of 2.62, reality shock score of 1.87, and non-occupational commitment score of 1.55. Such new nurses tend to prioritize the opinion of others while holding back their own, which is considered mentally burdensome and makes them prone to burnouts. Furthermore, their poor acceptance skill—one of the assertive attitudes—-makes it difficult for them to accept their work environment and find meaning in their work. In addition, an association was observed among the work environment perception of new nursing staff who had no advisers, burnout, reality shock, and non-occupational commitment. This review suggests that the assertiveness of new nursing staff may be related to their perception of the work environment.